Kidney and Liver Diseases

The kidneys filter your blood and keep fluid and minerals in balance. The liver processes food, medicines and waste, and makes proteins your body needs every day. Both organs can lose function slowly and quietly over years, which is why so much of the care here is about blood tests rather than symptoms. This page is a way in to the specific conditions.

Conditions in this area

• Chronic kidney disease: the kidneys filter less well over time, affecting about 1 in 10 people in Canada, and more than 90 per cent of early stage disease has not been diagnosed.
• Fatty liver disease: fat builds up in the liver, usually without symptoms, and in some people leads to inflammation and scarring. An estimated 9.2 million people in Canada are affected.
• Gallstones and gallbladder disease: hard stones form in the bile stored under the liver, silent in most people and causing attacks of pain in others.
• High blood pressure: one of the two leading causes of kidney failure in Canada, and something that usually causes no symptoms until damage is done.
• Diabetes: the other leading cause of kidney failure, and a major driver of fatty liver disease, affecting about 3.9 million people here.

What these conditions have in common

Both organs handle whatever is circulating in your blood, so they are affected by the same background conditions. High blood pressure, high blood sugar and metabolic health drive both chronic kidney disease and fatty liver disease. Both organs are usually assessed with ordinary blood and urine tests in primary care rather than with anything dramatic. Both tend to produce no symptoms until function is well down, and both can end in the same place: a transplant list.

The grouping is practical rather than biological. A gallstone attack and slow loss of kidney filtering have little in common beyond sitting in the same part of the body. High blood pressure and diabetes appear here because of what they do to these two organs, not because they are kidney or liver diseases themselves.

Treatment and management in Canada

Clinical research for Kidney and Liver Diseases is enrolling. See the current studies ↓

Care in this area is mostly about protecting function that is still there, and about treating the conditions driving the damage. Depending on the diagnosis and stage, a health care team may discuss:

• Treating the causes, especially blood pressure, blood sugar and metabolic health
• Medicines chosen partly for their effect on the kidneys, including some diabetes medicines used for that reason
• Antiviral treatment for hepatitis B or C, when either is found
• Dietitian support, and a pharmacist review of medicines the kidneys have to clear
• Dialysis, in a centre or at home, when kidney function falls far enough
• Assessment for a kidney or liver transplant, including living kidney donation

Which of these applies depends on your test results, your other conditions and your own priorities. Those are decisions for you and your own clinician, and nothing here is a recommendation about any of them.

When to talk to a doctor

• Passing little or no urine, new confusion, severe shortness of breath or chest pain needs emergency care. Call 911 or go to an emergency department.
• In someone with known liver disease, vomiting blood, black tarry stools, a swollen painful abdomen or new confusion needs emergency care.
• Yellowing of the skin or eyes, dark urine or pale stools should be assessed promptly.
• Sudden severe pain under the right ribs, with fever or vomiting, needs same-day assessment.
• New swelling in the legs or around the eyes, blood in the urine, or persistently foamy urine is worth an appointment.
• If you live with diabetes or high blood pressure, ask when your kidney and liver tests are next due.

Why research in this area matters

Both diseases are usually found late, and until recently there was little that changed their course. That is starting to shift: some diabetes medicines turned out to slow the loss of kidney function, and the first treatments aimed at liver inflammation and scarring have moved through trials. Even so, most people with early disease do not know they have it, and once scarring is established the options narrow. Research here is testing medicines that slow progression, simpler ways to find disease earlier in primary care, and improvements in dialysis and transplant care.

Studies are how those questions get answered. Taking part is voluntary, you give informed consent before anything begins, and you can withdraw at any time without affecting the care you get from your own doctor. Joining a study does not mean giving up your current treatment, and no one can say in advance whether a study will help you personally.

Learn more from Canadian sources

• The Kidney Foundation of Canada
• Canadian Liver Foundation
• Canadian Institute for Health Information: organ replacement in Canada
• Canadian Blood Services: organ and tissue donation